CMC Beirut unveils advanced innovations in cardiovascular imaging

Clemenceau Medical Center, Beirut (CMC) continues to prioritize top-tier healthcare for its patients by equipping its Cardiovascular Imaging Department with cutting-edge technology. These advance­ments enable precise and prompt diagno­sis of heart diseases, assisting physicians in making timely treatment decisions. This commitment solidifies Clemenceau Medi­cal Center’s leadership in accurately diag­nosing and treating cardiovascular condi­tions in Lebanon and the wider region.

The Center’s role is a premier and re­ferral destination for Cardiovascular care. Non-invasive Cardiology has progressively evolved during the past years and under­gone significant upgrades, most notably in the field of Cardiac and Vascular Imaging. The Revolution APEX Cardiac CT scan is a state-of-the-art device and among the most advanced globally, and CMC Beirut is proudly the first facility in the Middle East to offer this technology to the patients.

One of the key benefits of this new tech­nology is the substantial reduction in radia­tion exposure, making the imaging process safer, particularly for patients who require frequent scans. Additionally, advanced technology allows to use less contrast dos­age to achieve high-quality images, which is especially beneficial for patients with chronic kidney disease.

Advanced CT
The Revolution APEX CT scan also fea­tures the Single Beat Acquisition and the Snapshot Freeze Algorithm technology, en­abling to capture high-quality images even when a patient’s heart rate is elevated. This is a significant achievement compared with older machines that required an average heart rate of 60 beats per minute to perform good quality images. The advancements in speed and sensitivity in the new machine allow imaging cardiologists to obtain high-quality images with a faster heart rate.

Moreover, the Center is now providing FFR-CT (Fractional Flow Reserve CT), the first of its kind in Lebanon and the Middle East. It is a new technology and a new type of non-invasive procedure (no incisions or interventions required) which uses flow analysis to determine whether the heart muscle suffers from ischemia, particularly in cases where the coronary ar­tery blockage is moderate between 50 and 70%. Additionally, the American Heart Association / American College of Cardi­ology guidelines highlight the use of FFR-CT in patients with 40% to 90% blockage. The role of the expert imaging cardiologist is to provide accurate information for interpretation, and thorough evaluation of the coronary artery tree and validation of the results provided by the technology, so that the final results are accurate enough. FFR-CT is safe as compared to invasive FFR which requires intervention. Moreover, it has shown to be accurate (91% specificity) and non-inferior to invasive FFR. This non-invasive technique allows to accurately assess blood flow in the coronary arteries, aiding in the diagnosis of coronary artery diseases and guiding appropriate treatment decisions. For instance, with a negative result, unnecessary invasive procedures can be avoided. 

Nevertheless, the integration of Artificial Intelligence (AI) in cardiac CT scanning has significantly enhanced diagnostic efficiency. AI-powered algorithms enable the rapid and accurate processing of images, allowing us to examine more patients in a shorter amount of time while still delivering precise results.

AI also automates the analysis of the images, identifying coronary arteries and other critical structures, which saves a considerable amount of time and effort. This allows doctors to focus on more complex aspects of the diagnosis. However, the physician’s role remains essential in the diagnostic process, as they review the AI-generated results and provide the final diagnosis.

Overall, these technological advancements in cardiovascular CT allow to provide more accurate and precise imaging while reducing the risks associated with traditional scans.

Cardiovascular MRI
On the other hand, Cardiovascular Magnetic Resonance Imaging (MRI) is indeed a valuable addition and a crucial test to our imaging capabilities, and it has seen significant improvements with the integration of AIR™ Recon DL technology into our 3 Tesla MRI machine. This upgrade has greatly enhanced image quality, reduced scanning time, and enabled us to use advanced techniques like T1-T2 mapping, tagging and strain.

These advancements allow for accurate diagnosis of heart muscle diseases, such as abnormalities in cardiac contraction and deformation, subtle fibrosis, and myocardial edema. The new CVI42 software, supported by AI, streamlines the analysis process and improves the accuracy of our diagnostic results.

3D/4D echocardiography
CMC is also excited to offer the latest in 3D/4D echocardiography with the VIVID E95 Ultra Edition. This advanced machine provides high-resolution images and is powered by AI as well, allowing for incredibly precise diagnoses of heart conditions. AI algorithms enable the Vivid E95 Ultra Edition to reduce manual steps and help improve the efficiency of the workflow through automated processes, with up to 80% fewer klicks thanks to AI Auto Measure 2D.

The machine is also equipped with several imaging functions that are unique across the Vivid product family. Flexilight for example allows the photorealistic illumination of rendered 4D images, while 4D Auto TVQ enables fast, reproducible and accurate 4D visualization and quantification of the tricuspid valve. The integration of the myocardial work function through the “automated function imaging” option has opened the door for more research.

Nevertheless, Vivid E95 Ultra Edition is the close partner for the interventional echocardiographer in accomplishing complex tasks. Specially developed tools allow to optimize intervention planning and thus reduce intervention time accordingly.

The choice of the imaging technique depends on the specific condition that is being investigated by the cardiologist or the referring physician. Generally, echocardiography is the first imaging tool that should be accessed in diagnosing heart disease. However, the need for more advanced imaging is often needed in cases where the diagnosis is not established. Cardiovascular MRI is the gold standard in assessing heart function and diagnosing ischemic and non-ischemic heart diseases, valvular diseases, the pericardium, congenital defects, and may others. On the other hand, cardiovascular CT is primarily used to assess the cardiac anatomy and the coronary arteries. CT also plays a pivotal role in planning for structural interventions, as it provides precise measurements for transcatheter valve replacement and device implantation procedures.

With all this technology installed at the heart of Beirut, CMC is able to provide diagnostic services that are on par with those offered at leading centers worldwide.